Screening and Diagnosis for professionals

This resource provides professionals with key signs and symptoms to look for when screening for autism, along with guidance on when to refer for further assessment.

Screening and Diagnosis for professionals

Screening and Diagnosis - A note for professionals

A pediatrician typically serves as the initial point of contact for a child and their family within the medical field. Therefore, it is of utmost importance that pediatricians vigilantly monitor a child's natural development.

General signs

  • Does not respond to name by 9 months of age
  • Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
  • Does not play simple interactive games like pat-a-cake by 12 months of age
  • Uses few or no gestures by 12 months of age (for example, does not wave goodbye)
  • Does not share interests with others by 15 months of age (for example, shows you an object that they like)
  • Does not point to show you something interesting by 18 months of age
  • Does not notice when others are hurt or upset by 24 months of age
  • Does not notice other children and join them in play by 36 months of age
  • Does not pretend to be something else, like a teacher or superhero, during play by 48 months of age
  • Does not sing, dance, or act for you by 60 months of age

Communication

  • Does not give or sustain eye contact
  • Delayed speech and language skills
  • Flat, robotic speaking voice, or singsong voice
  • Echolalia (repeating the same phrase over and over)
  • Problems with pronouns (saying “you” instead of “I,” for example)
  • Not using or rarely using common gestures (pointing or waving), and not responding to them
  • Inability to stay on topic when talking or answering questions
  • Not recognizing sarcasm or joking
  • Trouble expressing needs and emotions
  • Not getting signals from body language, tone of voice, and expressions
  • Restricted or repetitive behaviors and interests

Unusual interests or behaviours

People with ASD have behaviors or interests that can seem unusual. These behaviors or interests set ASD apart from conditions defined by problems with social communication and interaction only. Examples of restricted or repetitive behaviors and interests related to ASD can include:

  • Lines up toys or other objects and gets upset when order is changed
  • Plays with toys the same way every time
  • Is focused on parts of objects (for example, wheels)
  • Gets upset by minor changes
  • Has obsessive interests
  • Must follow certain routines
  • Flaps hands, rocks body, or spins self in circles
  • Has unusual reactions to the way things sound, smell, taste, look, or feel
  • Fussy eating habits
  • Lack of coordination, clumsiness
  • Impulsiveness (acting without thinking)
  • Aggressive behavior, both with self and others
  • Short attention span

Other Characteristics

Most people with ASD have other related characteristics. These might include

  • Delayed movement skills
  • Delayed cognitive or learning skills
  • Hyperactive, impulsive, and/or inattentive behavior
  • Epilepsy or seizure disorder
  • Unusual eating and sleeping habits
  • Gastrointestinal issues (for example, constipation)
  • Unusual mood or emotional reactions
  • Anxiety, stress, or excessive worry
  • Lack of fear or more fear than expected

When any of these signs are observed, it is advisable to recommend that the family consult with a developmental pediatrician who can conduct more extensive screening and assessments.

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